Interrelationship between bone turnover markers, calciotropic hormones and leptin in obese Saudi children.

OBJECTIVE: Fat-bone relationship involves the interaction among endocrine, inflammatory, immune processes and bone turnover. We tried to assess the association between Leptin and bone turnover markers (OCN, ß-CTx, ALP), calciotropic hormones PTH and 25(OH)D in obese Saudi children. PATIENTS AND METHODS: A cross-sectional study performed with 60 obese children and 36 lean children. For all subjects, OCN, ALP, ß-CTx, PTH, 25(OH)D, leptin, Ca and Pi were investigated. Levels of leptin were measured by [ELISA] method, and OCN, ß-CTx, PTH and 25-(OH)D by an electrochemiluminescence immunoassay. RESULTS: Sixty obese Saudi children had means weight (38.3 vs. 13.8 kg), height (121.0 vs. 91.8 cm) leptin (23.04 vs.16.88 ng/ml), PTH (31.5 vs. 14.7 pg/ml), Pi (1.67 vs. 1.54 mmol/l) were significantly higher and 25(OH)D (21.02 vs. 29.45 ng/ml) was significantly lower than controls. There was no difference in serum OCN, ß-CTx, ALP and calcium between groups (p > 0.05). In the correlation study, OCN were significantly positively correlated with height, ALP, age, PTH, and ß-CTx (r = 0.347, 0.32, p < 0.05), (r = 0.35, 0.51, 0.66, p < 0.01 respectively), while serum 25(OH)D was negatively correlated with PTH, weight, height and BMI (r = -0.45, -0.55, -0.55, -0.47, p < 0.01 respectively). PTH was positively correlated with leptin and ß-CTx (r = 0.41, 0.44, p < 0.01), but not to ALP and BMI percentile. ß-CTx correlated significantly positive with Pi (r = 0.34 p < 0.05) and ALP with BMI percentile (r = 0.42, p < 0.05). Multiple regression analysis demonstrated that PTH was predicted by leptin and ß-CTx (R2 = 0.55); ß-CTx by leptin and OCN (R2 = 0.498); OCN by PTH and ß-CTx (R2 = 0.47); and 25(OH)D by PTH (R2 = 0.21). CONCLUSIONS: The obese children had increased levels of leptin and PTH with strong associated with bone turn over markers OCN, ß-CTx and deficiency of 25(OH)D which may be playing an important role in the pathogenesis of obesity and related bone metabolic risk diseases as osteoporosis and fractures.

A novel association between IL1-Ra (receptor antagonist) gene polymorphism and T1DM in Al-Madina Al-Mounawra.

OBJECTIVE: The Interleukin-1 receptor antagonist (IL1-Ra) is initiated to terminate the acute pro-inflammatory event and prevent chronic inflammation from damaging healthy cells. We aim to draw the attention of IL1-Ra (VNTR) gene polymorphism and determine whether IL1-Ra confer susceptibility to type 1 diabetes mellitus (T1DM) and evaluate the genotype and allele distribution of IL1-Ra gene in a Saudi population. PATIENTS AND METHODS: Case control study included (100) T1DM Saudi children, plus 102 healthy unrelated individuals as control group. They were evaluated for variable number of tandem repeat (VNTR) of IL1-Ra gene polymorphism. Polymerase chain reaction amplification of VNTR of 86bp in intron 2 of IL1-Ra was performed. RESULTS: A1A1 and A1A2 genotypes with alleles A1 and A2 frequency were the most common both in cases and controls (healthy population); prevalence (28%, 56% & 57.8%, 39.2% respectively) and (58%, 38% and 77.5%, 22.5% respectively). In addition IL1-Ra gene polymorphism had higher risk significantly different between diabetic children and controls. (A1/A2) genotype had higher frequency statistically significant in DM patients than controls [56% vs. 39.2%, p < 0.02] and had twice time risk [OR = 1.97, 95% CI = 1.1-3.4, p < 0.02]. With further stratification, there was strong association between diabetic patients carriage IL1-Ra (A2) allele and controls [38% vs. 22.5%, p = 0.001] which had higher risk [OR = 2.11, 95% CI = 1.4-3.2, p = 0.001] for susceptibility of diabetes. CONCLUSIONS: This study emphasizes a positive association between IL1-Ra (VNTR) polymorphism and DM among Saudi children. This may suggest that (A2) allele may play important role in disease susceptibility.